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2007 lorem ipsum dolor met set quam nunc parum Targeting Health Workers for Case Management Training at all levels Malaria Consortium offers an alternative to the cascade model of training Dr. Mwiche, the Provincial Communicable Disease Control Specialist, facilitates case management training in Katete District, Zambia in June 2009. Providing prompt, effective treatment for malaria remains an unmet goal for health centres across Zambia. The Zambian Ministry of Health has called attention to the human resource crisis in the health system, which undermines its capacity to provide even the most basic health care services to its people. The health system has suffered further deteriorations due to high staff attrition rates attributed to the migration of health professions, along with HIV/AIDS related deaths. The extent of the crisis is such that many Rural Health Centres have no staff or are staffed by untrained personnel, and new centres have been opened without additional staff to run them. The photo to the right shows two casual daily employees who are the only staff members at their clinic. In response, Malaria Consortium has designed a case management training that targets all levels of staff, to ensure that any staff member handling malaria cases knows the correct protocols. [The most important principles of malaria case management are early and accurate diagnosis, prompt and effective treatment, adherence to treatment, follow‐up and good nursing.] Malaria Consortium has invited Doctors, Clinical Officers, Registered and Enrolled Nurses, Environmental Health Technicians, Laboratory Staff, and Casual Daily Employees as well as Managers of District Health Units and Hospitals. After the trainings by qualified health professionals, follow‐up sessions take place at three, six and twelve month intervals. The training manual used during these workshops was written by the Case Management Technical Working Group, a team of experts including Malaria Consortium – International, and in Zambia, Malaria Consortium Country Office, National Malaria Control Centre, Provincial Clinical Care and Communicable Disease Control Specialists, and other health practitioners. The training focuses on accurate case detection and use of Rapid Diagnostic Tests, treatment, care for pregnant women, having confidence in rapid diagnostic These Casual Daily Employees rode over 150 kilometres to attend the Case Management Training in Chama. Although they have had no formal medical training, they are the only staff in their health centre, responsible for all the health care needs of their catchement area. Case Study - Zambia

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Page 1: Targeting Health Workers for Case Management Training at ......Targeting Health Workers for Case Management Training at all levels Malaria Consortium offers an alternative to the cascade

2007

lorem ipsum dolor met set quam nunc parum

TargetingHealthWorkersforCaseManagementTrainingatalllevels

MalariaConsortiumoffersanalternativetothecascademodeloftraining

Dr.Mwiche,theProvincialCommunicableDiseaseControlSpecialist,facilitatescasemanagementtraininginKateteDistrict,ZambiainJune2009.

Providingprompt,effectivetreatmentformalariaremainsanunmetgoalforhealthcentresacrossZambia.TheZambianMinistryofHealthhascalledattentiontothehumanresourcecrisisinthehealthsystem,whichunderminesitscapacitytoprovideeventhemostbasichealthcareservicestoitspeople.

Thehealthsystemhassufferedfurtherdeteriorationsduetohighstaffattritionratesattributedtothemigrationofhealthprofessions,alongwithHIV/AIDSrelateddeaths.TheextentofthecrisisissuchthatmanyRuralHealthCentreshavenostafforarestaffedbyuntrainedpersonnel,andnewcentreshavebeenopenedwithoutadditionalstafftorunthem.Thephotototherightshowstwocasualdailyemployeeswhoaretheonlystaffmembersattheirclinic.

Inresponse,MalariaConsortiumhasdesignedacasemanagementtrainingthattargetsalllevelsofstaff,toensurethatanystaffmemberhandlingmalariacasesknowsthecorrectprotocols.[Themostimportantprinciplesofmalariacasemanagementareearlyandaccuratediagnosis,promptandeffectivetreatment,adherencetotreatment,follow‐upandgoodnursing.]MalariaConsortiumhasinvitedDoctors,ClinicalOfficers,RegisteredandEnrolledNurses,EnvironmentalHealthTechnicians,LaboratoryStaff,andCasualDailyEmployeesaswellasManagersofDistrictHealthUnitsandHospitals.

Afterthetrainingsbyqualifiedhealthprofessionals,follow‐upsessionstakeplaceatthree,sixandtwelvemonthintervals.

ThetrainingmanualusedduringtheseworkshopswaswrittenbytheCaseManagementTechnicalWorkingGroup,ateamofexpertsincludingMalariaConsortium–International,andinZambia,MalariaConsortiumCountryOffice,NationalMalariaControlCentre,ProvincialClinicalCareandCommunicableDiseaseControlSpecialists,andotherhealthpractitioners.ThetrainingfocusesonaccuratecasedetectionanduseofRapidDiagnosticTests,treatment,careforpregnantwomen,havingconfidenceinrapiddiagnostic

TheseCasualDailyEmployeesrodeover150kilometrestoattendtheCaseManagementTraininginChama.Althoughtheyhavehadnoformalmedicaltraining,theyaretheonlystaffintheirhealthcentre,responsibleforallthehealthcareneedsoftheircatchementarea.

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Page 2: Targeting Health Workers for Case Management Training at ......Targeting Health Workers for Case Management Training at all levels Malaria Consortium offers an alternative to the cascade

testresults,andhowtotrackdatasothattheentiresystemcanrunsmoothly.

In2009,trainingwascarriedoutinfiveDistricts;twoinEasternProvince,andthreeinSouthernProvince,reachingover462healthfacilityworkersandapproximately100healthcentresincludingtworemoteDistricts,ChamaandItezhi‐Tezhi.

CentraltrainingcancostuptoUSD$1,000perpersonwhenitisheldatahotel.MalariaConsortiumhasdesignedamorecost‐effectivemodelwhichreachesmorehealthworkers,andmakesuseofthecentreswheretheymeetpatients.TrainerscamefromtherespectiveProvincialHealthOffices,allowingforeasyfollow‐up.Smallergroupsmeanthands‐ontrainingforparticipants,withalowteachertostudentratio.Thismodelallowedparticipantstogainpracticewithavailableequipment,makingoptimaluseoftheirtime.

Thetrainingprovidesbasicoperationalinformationandessentialskillsneededbyallhealthworkersinvolvedinmalariacasemanagement.Itsobjectiveistoraisecapacityofhealthstaffatalllevelsintermsoftheirabilitytoperformlife‐savinginterventions,transferringknowledgeintothemindsofthepeoplewhotakecareofpatientseveryday.

AttheendofaMalariaConsortiumtraininginJune2009,YoanaMbewe,acasualdailyemployeesaid,‘Thankyou.Weshouldcontinueinthisspirittoconsideruscasualdailyemployeestofindproblemswhenqualifiedstaffarenotthere.Butthistraininghastaughtusalotofthingssothatwhenweareatthe[health]centreweareabletodothework.’(TranslatedfromNyanja.)

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www.malariaconsortium.org

MalariaConsortiumZambiaPlot37L/2Middleway,Kabulonga,Lusaka,Zambia T+260211262715

HealthworkersataCaseManagementTraininginChama,inEasternProvince.